Mauritius Examinations Syndicate
Tel: (230) 4038400 Fax: (230) 4547675
______________________________________________________________________________________
Application
Form
Resource
Person for Monitoring of Coursework/Project Work to Examinations
SC/HSC Examinations
Section
Subject Area:
. Code:
.
..
1. Surname:
.
.
.
2. Other names:
.
...
3. Title Dr/Mr/Mrs/Miss1:
Date of birth:
.
.
....
.
4. Home address:
..
.
.
.
5. Telephone No. Office:
.
. Home:
...
.
. Mobile:
..
..
6. Email address:
.. NIC
No.:
.
7. Working
experience:
(Please continue on a separate sheet if necessary).
|
Dates |
Job Title |
Employer |
|
|
From |
To |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 Please delete as appropriate
8. Years of experience:
.
...
.
9. Academic/Professional Qualifications
(Post Secondary)2:
|
Qualifications (Diploma/Degree) |
Subject(s) |
Class/Division (if applicable) |
Awarding Body |
Award date |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
10.
Any other relevant information you may wish
to bring to the attention of the Syndicate.
|
.
.
.
.
.
.
.
.
. (Please continue on a
separate sheet if necessary). |
Date:
.
Signature:
.
..
2 Note: Please enclose copies of certificates.